Lyles C M, Margolick J B, Astemborski J, Graham N M, Anthony J C, Hoover D R, Vlahov D
Department of Epidemiology, Johns Hopkins School of Hygiene and Public Health, Baltimore, Maryland, USA.
AIDS. 1997 Aug;11(10):1255-62. doi: 10.1097/00002030-199710000-00009.
To assess the relationship between various injecting drug use patterns and the rate of CD4+ lymphocyte decline in HIV-1-infected injecting drug users in Baltimore, Maryland, USA.
A cohort of 605 HIV-1-infected injecting drug users was recruited between 1988 and early 1989 in East Baltimore using extensive community outreach techniques. The participants were interviewed semi-annually to collect information on drug use practices. The outcome measure of interest was the rate of CD4+ lymphocyte decline between pairs of CD4+ lymphocyte counts. A mixed model was used to evaluate the relationship between the change in CD4+ lymphocyte count per month and previous CD4+ lymphocyte count and various drug use variables.
The 605 HIV-infected injecting drug users had a median initial CD4+ lymphocyte count of 513 cells x 10(6)/l. Using 3209 paired observations, the mean change in CD4+ lymphocyte count was -3.2 cells x 10(6)/l per month. The rate of decline was higher in those with a higher level of CD4+ lymphocytes (P < 0.01) and length of drug use (P < 0.01), but did not vary by injection frequency or injection intensity of specific drug types. Although animal studies have suggested that the pattern of drug administration (continuous versus intermittent) and episodes of withdrawal or overdose might impact the rate of CD4+ lymphocyte decline, this was not observed in the present study.
Patterns of injecting drug use, based on self-report, were not associated with the rate of decline in CD4+ lymphocytes.
评估美国马里兰州巴尔的摩市感染人类免疫缺陷病毒1型（HIV-1）的注射吸毒者的各种注射吸毒模式与CD4+淋巴细胞下降率之间的关系。
1988年至1989年初，在东巴尔的摩采用广泛的社区外展技术招募了605名感染HIV-1的注射吸毒者。每半年对参与者进行一次访谈，以收集有关吸毒行为的信息。感兴趣的结局指标是成对CD4+淋巴细胞计数之间CD4+淋巴细胞的下降率。使用混合模型评估每月CD4+淋巴细胞计数变化与先前CD4+淋巴细胞计数及各种吸毒变量之间的关系。
605名感染HIV的注射吸毒者初始CD4+淋巴细胞计数中位数为513个细胞×10⁶/l。利用3209对观察数据，CD4+淋巴细胞计数的平均变化为每月-3.2个细胞×10⁶/l。CD4+淋巴细胞水平较高者（P<0.01）和吸毒时间较长者（P<0.01）的下降率更高，但下降率不因注射频率或特定药物类型的注射强度而有所不同。尽管动物研究表明给药模式（持续与间歇）以及戒断或过量用药发作可能会影响CD4+淋巴细胞下降率，但本研究未观察到这种情况。
基于自我报告的注射吸毒模式与CD4+淋巴细胞下降率无关。
